Necrotic locally advanced nasal NK/T-cell lymphoma: the timely diagnostic challenge

Extranodal NK/T-cell lymphoma (ENKTCL) is an aggressive and heterogeneous disease. It is a rare non-Hodgkin lymphoma observed primarily in Asian and south-American. countries. Most patients with ENKTCL present with early-stage disease. Herein we present a case of a male patient presented with chronic nasal symptoms, including bad smelling discharges. A midline necrotic lesion was detected on rhinoscopy with destruction of the nasal septum, and necrosis of the philtrum. The histopathological and flocytometry findings confirmed the diagnosis of Extranodal NK/T-cell lymphoma, nasal type, EBV positive, with Ki 67 at 95%. ENKTCL presents a diagnostic challenge due to its non-specific and often misleading symptomatology. Better awareness methods about ENKTCL early detection and combined modality therapy may enhance the treatment outcomes in this population of patients.